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Background

Owing to the fact that potential frequency of endothelial dysfunction and early atherosclerosis might be higher in Behcet's disease (BD), characterized with acute and chronic inflammatory attacks, it may lead to an impairment in flow-mediated dilation (FMD) and to an increase in epicardial adipose tissue (EAT) thickness. So, we aimed to evaluate whether EAT thickness and brachial artery FMD markers of early atherosclerosis and endothelial dysfunction were associated with BD.

Methods

35 patients with BD and 35 healthy volunteers were included in this study. EAT was identified as echo-free space between epicardial layers on 2-dimensional images and its thickness was measured on free wall of right ventricle. Right brachial artery FMD was assessed according to recent guidelines.

Results

Serum gamma-glutamyl transferase (GGT) levels and EAT thickness were higher (p=0.001, p<0.001 respectively), while flow-mediated, endothelium-dependent dilation was significantly lower in BD group than in control subjects (p<0.001). There was a significant negative association between EAT thickness and FMD (p<0.001) (Figure 1). EAT thickness was also positive correlated to BD activity (p<0.001), BD duration (p<0.001) and waist circumference (p<0.001). FMD was negatively correlated to GGT (p<0.001), BD activity (p<0.001), and age (p<0.001) (Table 1). There was also a significant association between GGT and BD activity (p<0.001).

Conclusıons

Based on these findings, we considered that increased EAT thickness and impaired FMD are likely to be predictors of early atherosclerosis in patients with BD.

Standard coefficient (β)

P value*

Independent variables

Dependent variable: Epicardial adipose tissue thickness

Disease activity

0.453

0.001

Disease duration

0.306

0.021

Waist circumference

0.254

0.023

Independent variables

Dependent variable: Flow-mediated dilation

GGT

-0.455

0.001

Disease duration

-0.367

0.003

Age

-0.212

0.029

* Linear regression analyses using the stepwise method were used for the multivariate analysis of independent variables that were included if they were significantly different in the univariate analyses (P<0.1). GGT= Gamma glutamyl transferase.

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